• In most of the nearly 2,600 counties included in the analysis, the plans identified as benchmark plans, and the premiums for these plans, changed from year to year. For example, in 85 percent of counties, the 2015 benchmark plans were not benchmark plans in either 2016 or 2017.

• Gross benchmark premiums (exclusive of tax credits) increased from year to year, and increases were higher from 2016 to 2017 than they were from 2015 to 2016.

• Premium tax credits would limit the costs of increasing premiums for most consumers, though some consumers, including those not eligible for premium tax credits, would have incurred more or all of the higher premium costs.
During the annual open enrollment period, consumers who

]]>CRS FAQs on the Affordable Care Acthttp://benefitsforward.com/2017/12/12/crs-faqs-on-the-affordable-care-act/
Tue, 12 Dec 2017 14:59:20 +0000http://benefitsforward.com/?p=5145The Congressional Research Service produced this Frequently Asked Questions to assist Congressional staffers in responding to constituents with questions about the Affordable Care Act.

]]>Executive Order On Health Carehttp://benefitsforward.com/2017/10/13/executive-order-on-health-care/
Fri, 13 Oct 2017 14:39:37 +0000http://benefitsforward.com/?p=5060President Trump signs an Executive Order authorizing insurance companies to sell health insurance policies across state lines. The order would require the DOL to issue guidance making it easier to maintain association plans. The order also encourages short-term plans and HRAs.

Document Excerpt
At the request of the House Democratic Leader and the House Democratic Whip, the Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) have estimated the effects of terminating those payments for cost-sharing reductions (CSRs). In particular, the agencies analyzed what would happen under this policy: By the end of this month, it is known that CSR payments will continue through December 2017 but not thereafter.

Instead, it added language whose most naturalreading is to enable a plan “maintained” by a principal-purpose organization to substitute for a plan both “established” and “maintained” by a church. And as a corollary to that point, the employees’construction runs aground on the so-called surplusage canon—thepresumption that each word Congress uses is there for a reason.

]]>Small Business will be allowed to Bypass the ACA Marketplacehttp://benefitsforward.com/2017/05/16/small-business-will-be-allowed-to-bypass-the-aca-marketplace/
Tue, 16 May 2017 15:11:15 +0000http://benefitsforward.com/?p=4920CMS has announced that small businesses will be allowed to bypass the SHOP, the Affordable Care Act Marketplace designed for small businesses.

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CMS will be exploring a more efficient implementation of the Federally-facilitated SHOP Marketplaces in order to promote insurance company and agent/broker participation and make it easier for small employers to offer SHOP plans to their employees, while maintaining access to the Small Business Health Care Tax Credit. CMS intends to propose rulemaking that would change how small employers and employees in SHOPs using HealthCare.gov enroll in SHOP plans taking effect on or after January 1, 2018. Under the approach CMS intends to propose, instead of enrolling online at HealthCare.gov, employers would enroll directly with an insurance company offering SHOP plans, or with the assistance of an agent or broker registered with the Federally-facilitated SHOP. Under the intended approach, employers would still obtain a determination of eligibility by going to HealthCare.gov. Employers that have enrolled in SHOP coverage for plan years that began in 2017 would be able to continue using HealthCare.gov in 2018 for enrollment and premium payment, until their current plan year ends and it’s time to renew. Employers can sign up for SHOP coverage taking effect in 2017 on HealthCare.gov until November 15, 2017. Under the approach CMS intends to propose, it is anticipated that states operating State-based SHOP Marketplaces would be able to provide for online enrollment, or could opt to direct small employers to insurance companies and SHOP-registered agents and brokers to directly enroll in SHOP plans.

]]>Fourth Circuit’s Decision on Removal of Reynolds Stockhttp://benefitsforward.com/2017/05/10/fourth-circuits-decision-on-removal-of-reynolds-stock/
Wed, 10 May 2017 13:31:39 +0000http://benefitsforward.com/?p=4907The Fourth Circuit affirms the district court’s decision concluding that the fiduciaries’ decision to remove Reynolds stock did not cause the losses because a prudent fiduciary would have made the same divestment decision at the same time.

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The “would have” standard does not demand such an impossible feat. Having a standard in which the fiduciary is held liable regardless of whether an outcome is foreseeable is akin to having no standard at all, eliminating the purpose of the loss causation analysis. Neither ERISA nor the efficient market theory requires that fiduciaries shoulder such burden or absorb such risk. As the Supreme Court explained in Fifth Third, a fiduciary cannot be required to predict the future. See 134 S. Ct. at 2472. For this very reason, our previous opinion left open the possibility that, when the district court applied the correct, more rigorous “would have” standard, the court would find that RJR had met its burden. Given the substantial record evidence supporting the district court’s holding, we cannot conclude that the district court erred.

]]>CBO Estimates Of American Health Care Acthttp://benefitsforward.com/2017/05/09/cbo-estimates-of-american-health-care-act/
Tue, 09 May 2017 14:59:06 +0000http://benefitsforward.com/?p=4904The CBO has released its estimates of the direct cost and effect of the American Health Care Act passed by the House.

Document Excerpt

CBO and the staff of the Joint Committee on Taxation (JCT) have prepared an estimate of the direct spending and revenue effects of H.R. 1628, the American Health Care Act, as posted on the website of the House Committee on Rules on March 22, 2017, incorporating manager’s amendments 4, 5, 24, and 25.

As a result of those amendments, this estimate shows smaller savings over the next 10 years than the estimate that CBO issued on March 13 for the reconciliation recommendations of the House Committee on Ways and Means and the House Committee on Energy and Commerce. The estimated effects on health insurance coverage and on premiums for health insurance are similar to those estimated for the committees’ recommendations.

]]>Section-by-Section Summary of American Health Care Acthttp://benefitsforward.com/2017/05/05/section-by-section-summary-of-american-health-care-act/
Fri, 05 May 2017 14:45:23 +0000http://benefitsforward.com/?p=4898The House, on a partisan vote, passed the American Health Care Act designed to repeal and replace the Affordable Care Act.

]]>HHS Finalizes Market Place Stabilization Rulehttp://benefitsforward.com/2017/04/17/hhs-finalizes-market-place-stabilization-rule/
Mon, 17 Apr 2017 15:17:27 +0000http://benefitsforward.com/?p=4883The HHS has released its final marketplace stabilization rule which includes a broader ability to offer policies that are below the ACA standards as well as a reduced open enrollment period.

Document Excerpt

This rule finalizes changes that will help stabilize the individual and small group markets and affirm the traditional role of State regulators. This final rule amends standards relating to special enrollment periods, guaranteed availability, and the timing of the annual open enrollment period in the individual market for the 2018 plan year; standards related to network adequacy and essential community providers for qualified health plans; and the rules around actuarial value requirements.